Psychometric evidence of spasticity measurement tools in cerebral palsy children and adolescents: a systematic review

To conduct a systematic review using validated critical appraisal scales to analyze both the quality and content of the psychometric evidence of spasticity measurement tools in cerebral palsy children and adolescents. The literature search was performed in 3 databases (Pubmed, CINAHL, Embase) up to March 2012. To be retained for detailed review, studies had to report on at least one psychometric property of one or many spasticity assessment tool(s) used to evaluate cerebral palsy children and adolescents. Two raters independently reviewed admissible articles using a critical appraisal scale and a structured data extraction form. A total of 19 studies examining 17 spasticity assessment tools in cerebral palsy children and adolescents were reviewed. None of the reviewed tools demonstrated satisfactory results for all psychometric properties evaluated, and a major lack of evidence concerning responsiveness was emphasized. However, neurophysiological tools demonstrated the most promising results in terms of reliability and discriminating validity. This systematic review revealed insufficient psychometric evidence for a single spasticity assessment tool to be recommended over the others in pediatric and adolescent populations.